| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,470 |
9,010 |
$696K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,834 |
5,896 |
$616K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
938 |
870 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
272 |
255 |
$27K |
| 96127 |
|
3,987 |
3,541 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
256 |
247 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,433 |
2,177 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
133 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
98 |
93 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
156 |
150 |
$4K |
| 99051 |
|
237 |
210 |
$3K |
| D1206 |
Topical application of fluoride varnish |
115 |
115 |
$3K |
| 90648 |
|
138 |
130 |
$3K |
| 92551 |
|
211 |
195 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
164 |
158 |
$2K |
| 90670 |
|
95 |
88 |
$2K |
| 99173 |
|
317 |
298 |
$2K |
| 90723 |
|
50 |
46 |
$1K |
| 99457 |
|
29 |
29 |
$877.77 |
| 90686 |
|
46 |
43 |
$865.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
36 |
30 |
$754.99 |
| 90734 |
|
29 |
28 |
$558.72 |
| 90633 |
|
16 |
16 |
$302.64 |
| 90715 |
|
14 |
14 |
$302.64 |
| 90651 |
|
12 |
12 |
$279.36 |
| 90680 |
|
16 |
14 |
$256.08 |
| 96161 |
|
91 |
84 |
$245.14 |
| 3008F |
|
803 |
752 |
$165.00 |
| 99454 |
|
29 |
29 |
$0.00 |